<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ims_vlan_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ims_vlan_id" data-rule="required" data-source="ims/vlan/index" data-field="vlanid" class="form-control selectpage" name="row[ims_vlan_id]" type="text" value="{$row.ims_vlan_id}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ims_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ims_number" data-rule="required" class="form-control" name="row[ims_number]" type="text" value="{$row.ims_number}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ims_password')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ims_password" data-rule="required" class="form-control" name="row[ims_password]" type="text" value="{$row.ims_password}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Gateway_username')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-gateway_username" data-rule="required" class="form-control" name="row[gateway_username]" type="text" value="{$row.gateway_username}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Gateway_password')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-gateway_password" data-rule="required" class="form-control" name="row[gateway_password]" type="text" value="{$row.gateway_password}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
